Patient dies and hundreds deteriorate after NHS Trust delays

One patient has died and hundreds of others have seen a deterioration in health after thousands of appointments were delayed at an NHS Trust.

Last year, 19,000 patients at the University Hospitals of Morecambe Bay NHS Foundation Trust saw delays in their outpatient appointments.

The Trust, which runs Furness General Hospital, the Royal Lancaster Infirmary, Westmorland General Hospital and Queen Victoria Hospital, said that all patients have since been seen but 663 patients "may have been affected to some degree" by the delay.

Tim Farron, Liberal Democrat MP for Westmorland and Lonsdale, said he knew of one cancer patient who died after a delay.

After a four- or five-month delay, doctors found her stomach cancer had spread and she later died.

The news comes as the Care Quality Commission (CQC) released a damning report about the Trust.

The CQC said that patients "remained at risk of poor care" at the Trust - particularly when they visited the hospital in urgent need.

CQC investigators, who visited the trust between January and March this year, noted long delays in accident and emergency and a lack of regard for the privacy and dignity of patients in mixed-sex wards.

Staffing levels were "inadequate", and there were failures in the monitoring of patients and unnecessary delays in discharging patients.

Patients were also moved frequently from one ward to the next and there was an inconsistency in the medical review of patients.

Investigators found a dislocation between senior managers and doctors leading to a lack of leadership to address the trust's problems.

The Royal Lancaster and Furness General Hospital were not meeting national targets to admit, discharge or transfer patients in emergency wards within four hours.

As a result of the investigation, the CQC issued the trust with warnings over its use of mixed-sex wards and failings in the way patients were monitored.

It criticised the hospitals belonging to the trust for not working together to "drive change" in improvements in care.

However, investigators noted that recent changes in management have resulted in actions to address many issues highlighted in the report

Amanda Sherlock, CQC director of operations, said: "This investigation allowed us to take an in-depth look at the care patients received as they entered the hospitals for emergency care and at what happened to them subsequently.

"The standards of care we found were not good enough, with people waiting too long to be seen, too few staff on duty, patients not being monitored properly and patients being accommodated in mixed-sex wards, or sometimes in wards not appropriate to their condition.

"A clear message from our investigation is that the trust needs firm leadership and robust governance systems to make sure everyone pulls in the same direction. It is especially important for clinicians and managers to work together.

"The new leadership of the trust appears to be responding positively to our concerns. They need to maintain this impetus and, importantly, ensure that improvements are sustained."

Mr Farron said: "This damning report sadly shows what happens when you send all South Lakes patients to hospitals that weren't designed to cope.

"The previous management didn't listen to medical staff and didn't listen to the public either. That's why they made such bad decisions, such as closing our heart unit at Westmorland General Hospital. Simply put, the previous management were not fit to run a medial trust."

The trust's chair, Sir David Henshaw, said: "We accept the findings of the investigation report by the Care Quality Commission and the trust board sincerely apologises for the way in which patients have been let down.

"This report is a snapshot in time, from an investigation that began nearly six months ago. Significant progress has been made since then to ensure services are safe as patient safety is our number one priority.

"In this time, a new trust board has been established and we will shortly be announcing our new chief executive.

"Like the CQC, when I joined the trust, I also identified a disconnect between clinicians and managers. It is critical that clinicians lead our divisions to ensure patients are at the centre of decision-making.

"That is why we now have doctors, nurses, midwives and allied health professionals in charge of our clinical services, with support from managers, not the other way around.

"However we know we still have to do more to raise standards of care across our hospitals and ensure the changes that we are making are sustainable. This trust will not preside over unsafe services."

In response to the delays in care, George Nasmyth, medical director at the trust, said: "I would like to take this opportunity to sincerely apologise, on behalf of the trust, to all those patients whose appointments were delayed.

"We have now reviewed the records of these patients and this shows that, regrettably, as a consequence of the delayed appointments, the care of a number of patients may have been affected and did not reach the standard which we expected.

"These patients are now getting the appropriate care but we are writing to each of them to offer them the opportunity to discuss what has happened with one of our consultants in addition to any ongoing treatment."